“A woman dies from heart disease every 34 seconds”- American Heart Association
“Heart disease claims more women’s lives than the next 8 causes of deaths combined . . . including breast cancer”- American Heart Association
“Heart attacks are generally more severe in women than in men”
These are startling facts. We recently lost the ‘King of Pop’ to cardiac arrest. For a moment’s consideration, if we isolate the overwhelming emotion of losing such a legend and just focus on the gender, it suddenly doesn’t seem so oblivious. Over the years, we have come to believe that heart related deaths occur only in men. However, increasing number of studies have shown that women are equally, or sometimes more susceptible to a heart disease than men, leading to their inclusion in major clinical trials today. Hence present times call for old beliefs being replaced by facts stated above, clearing misperceptions and women having a deeper understanding of the disease, its manifestation pattern, risk factors and preventive measures.
How is Menopause a Risk Factor for Heart Disease?
Women seem to be protected from heart disease till the age of 45, after which they lose that advantage over men. After the age of 65 women have the same risk as men for having a heart attack or stroke, and more risk of dying from either.
Optimum hormonal levels are vital in maintaining cell functions and the obvious depletion of estrogen during menopause is what makes women vulnerable to heart disease. Estrogen plays an important role in regulating levels of ‘good’ (HDL) and ‘bad’ (LDL) cholesterol in the body. It essentially acts on the liver to increase HDL levels and decrease LDL levels.
Reduction in estrogen therefore automatically raises LDL cholesterol in the body, causing it to accumulate in and clog arteries. Furthermore, deposition of cholesterol in the arteries causes local inflammation and more blockages.
Why is Heart Disease More Serious in Women?
The answer is simple. The manifestation of the disease is different and women do not experience those classic symptoms of a heart attack. One symptom glaringly absent is ‘chest pain’. Instead, studies claim that the following are subtle symptoms experienced by women:
- Excessive fatigue
- Lack of sleep
- Indigestion or heart burn
- Anxiety
- Shortness of breath
- Excessive sweating
- Neck or upper back pain
- Nausea and vomiting
These warning signs are either misdiagnosed to be a consequence of stress or a busy lifestyle or more often, ignored, contributing to the escalating figure of sudden cardiac deaths in women. Women also have more endurance to cardiac pain and hence do not seek serious medical attention that they may require.
Identifying Risk Factors to Avoid Heart Disease
Menopause doubles or sometimes even triples a woman’s risk of cardiovascular disease. Like menopause, there are other risk factors like age, family history of the disease and race, which cannot be modified. However, a few lifestyle practices, if kept under check can definitely reduce one’s cardiovascular risk.
- Exercise: Research shows that a single bout of intense exercise may increase oxidative stress in the body, causing more harm. However, following a regular regime comprising of moderate exercise can reduce cardiovascular risk manifold. Consult a healthcare provider and build an exercise program according to your comfort level.
- Reduce Stress: Stress makes the blood vessels to constrict, and increase blood pressure. It is therefore important to manage stress effectively and get adequate rest and relaxation. Deep breathing, exercise, yoga helps in reducing mental stress.
- Maintain a Healthy Weight: Heart of an overweight person is constantly under pressure to pump harder and consumes more oxygen. Reducing obesity and therefore pressure on the heart is important in keeping cardiovascular disease at bay.
- Control Diabetes Mellitus: Chronic diabetes is known to cause end-organ damage, with high sugar levels hastening the thickening of blood vessels, increasing blood pressure and eventually a collapse of the cardiac pump. Regular exercise and healthy eating habits need to be religiously followed to keep weight under check.
- Diet: A diet low in saturated and trans fats and rich in fruits, low fat dairy products and fibre reduce the chances of arteries getting clogged and hence preventing heart disease. A low salt diet helps in reducing blood pressure.
- Quit Smoking: Smoking is regarded as one of the leading risk factors for heart disease and effect women more severely than men. Taking the help of healthcare providers or programs to ‘quit smoking’ is advised. Women smokers are at a far greater risk of heart disease than men who smoke equal amounts.
Dealing with menopause isn’t easy. It not only brings emotional distress upon some women but could be a precursor to diminished health as well. While women cannot do away with menopause, the least they can do is to be aware and take care of themselves to keep other menopause related diseases at bay.
Snigdha Taduri - I’m a medical biochemist by qualification. As a graduate student, research was my primary focus and it led me and my team mates ...
